Healthcare Provider Details

I. General information

NPI: 1356600837
Provider Name (Legal Business Name): ANDREA WARD REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4620 W CONCORDIA AVE
MILWAUKEE WI
53216-3350
US

IV. Provider business mailing address

4620 W CONCORDIA AVE
MILWAUKEE WI
53216-3350
US

V. Phone/Fax

Practice location:
  • Phone: 414-388-8293
  • Fax:
Mailing address:
  • Phone: 414-388-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1121494-30
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number1121494-30
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number1121494-30
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number1121494-30
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1121494-30
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number1121494-30
License Number StateWI
# 7
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number1121494-30
License Number StateWI
# 8
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1121494-30
License Number StateWI
# 9
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 10
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1121494-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: